北京肠易激综合征的流行病学研究——分层整群随机抽样研究

[An epidemiologic study of irritable bowel syndrome in Beijing - a stratified randomized study by clustering sampling].

作者信息

Pan G, Lu S, Ke M, Han S, Guo H, Fang X

机构信息

Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2000 Feb;21(1):26-9.

PMID:11860753

Abstract

OBJECTIVE

To explore the prevalence of irritable bowel syndrome (IBS) and its risk factors in Beijing.

METHODS

Phase I: a screening program for IBS was carried out in Beijing area according to symptoms using both Manning (modified including constipation) and Rome criteria. Random clustered sampling involving 2 486 subjects of the inhabitants was carried out under stratification of city, suburban and rural areas. Sample size of each studied area was in proportion to the population of the area. The range of age was 18 - 70. All subjects studied were requested to fill in a questionnaire assisted by trained doctors or medical students during the visit to their families. Phase II: a small number of patients who fulfilled the Manning criteria were further selected to undergo detail clinical examination in the hospital including laboratory examination, abdominal ultrasonography, colonoscopy or/and barium enema to exclude organic disease of the colon. Prevalence of IBS of the population was then adjusted by the rate of correct diagnosis during phase II study. Minnesota Multi - Personality Indices was used in some cases. Potential risk factors were explored by comparing frequencies among IBS group and non - IBS group using chi(2) and logistic analysis of multifactors.

RESULTS

The adjusted point prevalence of IBS in Beijing according to Manning criteria was 7.26%, in contrast to Rome criteria - 0.82%. Higher prevalence rate of IBS in the city (10.50%) than in rural areas (6.14%) (P < 0.001) was noticed. Male to female ratio was 1:1.15 with majority of IBS fell in age 18 - 40 (51.6%), and among intellectuals. Our study indicated that history of dysentery (OR = 3.00), exposure to coldness (OR = 1.55), ingestion of cold food and raw materials (OR = 1.24) might serve as the most important risk factors (P < 0.001). Patients with IBS seemed to have a higher tendency of abnormal personalities.

CONCLUSION

IBS is a common disorder in Beijing which deserves greater care.

摘要

目的

探讨北京地区肠易激综合征（IBS）的患病率及其危险因素。

方法

第一阶段：在北京地区根据症状采用曼宁标准（包括便秘的改良版）和罗马标准开展IBS筛查项目。在城市、郊区和农村地区分层的基础上，对2486名居民进行随机整群抽样。每个研究区域的样本量与该地区人口成比例。年龄范围为18至70岁。所有研究对象在医生或医学生家访时，在其协助下填写问卷。第二阶段：进一步挑选少数符合曼宁标准的患者到医院进行详细的临床检查，包括实验室检查、腹部超声、结肠镜检查或/和钡灌肠，以排除结肠器质性疾病。然后根据第二阶段研究中的正确诊断率对人群中IBS的患病率进行校正。部分病例使用明尼苏达多相人格量表。通过卡方检验和多因素逻辑分析比较IBS组和非IBS组之间的频率，探索潜在危险因素。

结果

根据曼宁标准，北京地区IBS校正后的时点患病率为7.26%，而根据罗马标准为0.82%。注意到城市地区IBS患病率（10.50%）高于农村地区（6.14%）（P<0.001）。男女比例为1:1.15，大多数IBS患者年龄在18至40岁（51.6%），且以知识分子居多。我们的研究表明，痢疾史（OR=3.00）、着凉（OR=1.55）、食用生冷食物和原料（OR=1.24）可能是最重要的危险因素（P<0.001）。IBS患者似乎有更高的人格异常倾向。